Provider Demographics
NPI:1174566673
Name:RICHARDS, WILLIAM A (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 TALBOT RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-2000
Mailing Address - Country:US
Mailing Address - Phone:410-542-6152
Mailing Address - Fax:410-367-5614
Practice Address - Street 1:2516 TALBOT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2000
Practice Address - Country:US
Practice Address - Phone:410-542-6152
Practice Address - Fax:410-367-5614
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG762103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD770981100Medicaid
MD770981100Medicaid
MDR09409Medicare UPIN